Under-utilized -carotene-rich crops of Vietnam
Le T. Vuong
Abstract
Solutions to micronutrient deficiencies that capitalize upon indigenous resources and
foodstuffs offer a long-term mechanism for elevating the health status of disadvantaged
people. In populations where intakes of animal foods are inadequate and food sources of
retinol are not economically possible, efficient use of carotene-rich plants may prevent
vitamin A deficiency. In Vietnam, the Gac fruit (Momordica Cochinchinnensis Spreng)
is an excellent source of beta-carotene (17-35 mg/100g of edible part). This fruit is
familiar to indigenous people and is easy to grow. However it has been under-utilized
because it is available only 3 months out of a year; there has been no effort to educate the
at-risk population about its nutritional benefit and research efforts in production or
preservation techniques have been lacking. This paper describes the fruit, compares its
nutritional value with familiar carotenoid-rich fruits, details its traditional usage in
preparing rice, and discusses the acceptance of this rice preparation (xoi gac) to
Vietnamese preschoolers in their daily diet. Financial support for research directed at
improving the production and preservation of indigenous -carotene-rich crops is needed
to alleviate the problem of vitamin A deficiency of children in northern Vietnam.
Introduction
In the battle against malnutrition, chronic vitamin A deficiency stands out as one of the
most resistant nutritional problems in developing countries, in spite of the fact that the
symptoms are not difficult to identify, the aetiology is well understood, treatments are
available, and in most cases a food source of retinol and provitamin A carotenoids is
plentiful.
Vitamin A deficiency in Vietnam
The problem of vitamin A deficiency among children was first recorded in 1958, with
1,502 hospitalized cases of keratomalacia in the northern region between 1951 and 1953
(1). However, it was not until 1985, when the prevalence of vitamin A deficiency
disorders (VADD) in school age children exceeded WHO's cut-off point criterion for a
public health problem, that VADD in Vietnam received international attention. This
triggered measures to control the problem and a program was begun to distribute high
dose vitamin A capsules to children under age 2 years in all provinces in 1990 (2-4).
Nevertheless, chronic vitamin A deficiency persists as one of the prevailing nutritional
problems among children in the rural areas of Vietnam (5). Physiologically, sub-clinical
deficiencies manifest as susceptibility to infection and growth retardation (6,7). As a
public health issue, such widespread infirmities have an equal or higher human and
economic cost in developing countries than the more advanced stages of deficiency.
Vitamin A distribution programs do not provide a long-term solution in the rural areas of
Vietnam for a number of reasons. Distribution in remote areas is difficult and
fragmentary, and can further be confounded by the unstable sociopolitical factors
common to emerging countries. Such programs are frequently not available to all age
groups of children, or to women of reproductive age. For people of lower economic
groups and inhabitants of rural areas, animal products, which can be the best source of
vitamin A, are not available in sufficient abundance to prevent vitamin A deficiency.
Our dietary assessment of 193 pre-schoolers in two communities of northern Vietnam in
1997 found that daily consumption of meat was less than 15g per child (8). A national
survey among 13,000 children in northern Vietnam in 1991 reported that consumption of
vegetables and fruits among the children with xerophthalmia was 13% of total energy,
significantly lower than that among children without xerophthalmia (24%) (9).
Plant food as source of pro-vitamin A
In the diet, vitamin A comes in two forms: preformed vitamin A and provitamin A.
Preformed vitamin A is usually in the form of retinyl ester, derived from animal tissue
such as egg, fish oils, and flesh, and organ meats. Milk, cream, butter, cheese and
fortified foods such as margarine also contain vitamin A. Vitamin A can also be obtained
from provitamin A carotenoids which can be converted enzymatically in the intestine and
liver to retinol. Carotenoids in plants are the primary dietary source of vitamin A
worldwide (10,11). The most efficient pro-vitamin A carotenoid is ß-carotene which is
abundant in yellow and orange fruits, such as mangoes, papayas, and yams and in green
leafy vegetables such as spinach, kale, sweet potato leaves, and sweet gourd leaves.
Consumption of foods rich in -carotene theoretically can replete individuals to a healthy
vitamin A status (12-17).
In the winter of 1997 and summer of 1998, dietary assessment, household-gardens and
market surveys were conducted in two communes in the low lands of northern Vietnam.
The fruits and vegetables that are available are listed in Table 1. Among the indigenous
plants of northern Vietnam, the Gac fruit (Momordica Cochinchinnensis Spreng) has the
highest B-carotene content (Table 2). Pro-vitamin A from orange fruits has been shown
to be more bioavailable than that from dark-green leafy vegetables (20). The seed
membrane and pulp of the gac fruit also contains a significant amount of oil, which is
essential for the absorption and transport of -carotene (21-23). This is especially
critical in this population where dietary fat intake is very low (24). Traditionally, Gac
seed and pulp are mixed with cooked rice to impart a red color and distinct flavour (2527). The local name of the dish is Xoi Gac. Because this dish is already well accepted,
promoting its consumption could produce a substantial increase in -carotene intake.
Momordica Cochinchinnensis Spreng (Gac) is botanically classified as
Family Cucurbitaceae, Genus Momordica,Species Cochinchinnensis.
This rampagenous perennial vine was given the name Muricia cochinchinensis by
Loureiro, a Portuguese missionary-priest who published Flora Cochinchinensis in 1790.
Later, Sprengel concluded that the plant belonged in the Linnean genus Momordica and
changed the name in 1826 (28). The Vietnamese name of Momordica cochinchinensis
Spreng is Day Gac (25-27,29-30). M. cochinchinensis is also indigenous to China,
Moluccas (Burma), Japan, India, Thailand, Laos, Cambodia, Philippines, Malaysia, and
Bangladesh (30-32). Other common names of the plant are listed in Table 3.
The plant can be cultivated either from seeds or root tubers. Leaves are alternate and
deeply three-to-five-lobed with toothed margins. The leaf stalk is glandular. The gac
plant is dioecious, that is, the male and female plants are separate. The flowers are paleyellow and solitary in the axils of the leaves (Picture 1). The production of
parthenocarpic fruits, which is of economic importance, can be accomplished using
growth regulators in the female plant in the absence of male plants. However induced
parthenocarpic fruits have no seed, whereas hand pollinated fruits contain 18 seeds per
fruit on average (33).
The plant starts flowering about 2 months after root tubers have been planted. Flowering
usually occurs in April and continues to July/ August and sometimes until September.
On average, it takes about 18-20 days for a fruit to mature from emergence of the bud of
the female flower. A plant produces 30 to 60 fruits on average in one season. The ripe
fruit is picked from August to February (34).
Fruits of M. cochinchinensis are large, densely aculaeate, and green, turning to dark
orange or red when ripe. Unlike that of the bitter gourd (Momordica charantia), the
exocarp (rind) of the gac fruit is hard and is covered with conical points one-eighth-inch
high. The gac fruit available in Vietnam comes in oblong and almost round shapes.
There are no differences in the ways the fruits are used or consumed. There are also
variations among different fruits with respect to their spine and fruit tips. In some fruits,
the spines are smooth and dense, whereas in some, they are hard and widely spaced. The
oblong types are 6-10cm in length and round types are 4-6 cm in length. In Vietnam ,
the oblong fruit weighs between 500g and 1600g and can be 10 to 13 cm long.
Shadeque and Baruah reported that in Assam, the fruit weighs from 1 to 3 kg (35).
Unlike bitter gourd, which is mostly harvested in the developmental stages, gac fruits in
Vietnam are only picked at maturity when the fruit is bright red and seeds are hardened.
The mesocarp of the M. cochinchinensis fruit is one-half-inch thick, spongy and orange.
The core is divided into cartilaginous chambers containing bright red fleshy seed pods
(Picture 2). Each fruit has on average between 15 to 20 round, compressed and
sculptured seeds. The seed membrane and kernels contain oil and are used in traditional
medicine (25-27,32). There is no record of any use of the mesocarp. The average weight
of the pulp is about 19% of the total fruit weight. An average gac fruit weighing 1kg
yields approximately 190g of fruit pulp and 130g of seeds. The seed pulp of a ripe fruit
is bright red in color and has a palatable bland to nutty taste.
Nutritional composition of M. cochinchinensis seed pulp
Carotenoid was first identified in gac fruit by Guichard and Bui in 1941 (29). A
Vietnamese publication reported that 100g of gac pulp contain 45,780 g of -carotene
(27). Our chemical analyses of carotene contents gac pulp have been described
elsewhere (8). In ripe gac fruit, -carotene is the dominant carotenoid with concentration
as high as 35,500 g/ 100g. The mean concentration of -carotene in Gac fruit from 4
separate HPLC (high-performance liquid chromatography) assays was 26.06  9.38 mg
per 100g. In addition to -carotene, lycopene was the only carotenoid present in
quantifiable amounts. West and Poovlet reported a concentration of 18,810 g of carotene and 89,150 g of total carotenoids per 100g (18).
In addition to carotene, gac pulp also contains a significant amount of oil. Fatty acid
analyses indicate that gac contains 10,198 mg per 100g of edible portion. Of the total
fatty acids of gac pulp, 70% are unsaturated, 50% of these are polyunsaturated. The
approximate nutrient composition of gac fruit and pulp is shown in Table 4, and the fatty
acid composition of gac pulp is given in Table 5.
Traditional use of the gac fruit in Vietnam
In Vietnam, the gac vine is often seen growing on lattices at the entrances of rural homes.
The Vietnamese use the seed membranes and the pulp of the fruit in the preparation of
xoi gac (red rice) (25-27,32). Traditionally, xoi gac is served at weddings, the New Year
(Tet), and for other important celebrations (27). During these occasions, it is essential to
mask the white colour of rice, since white is considered the colour of death. To make xoi
gac, the pulp of gac fruit is mixed with rice. The seeds are often left in the rice, as proof
of authenticity (Picture 3). The color and fatty acids from the fruit pulp and seed
membrane are stirred into the rice, giving it a lustrous appearance and oil-rich taste. The
name xoi gac means red rice; and when the gac fruit is not in season, rice with red food
colourant is also called xoi gac, which local people occasionally eat for breakfast. In
addition to their use in xoi gac, the seed membranes are also used to make a tonic (gac
oil) for lactating or pregnant women and children, to treat "dry eyes" (xerophthalmia),
and night blindness. Vo reported that when applied to wounds, skin infections, and
burns, gac oil stimulated the new growth of skin, and closure of wounds (25). A
document on Vietnamese traditional medicine lists the use of the gac seed membrane,
which contains ß-carotene and lycopene, to treat infantile rachitis, xerophthalmia and
night-blindness. The report notes that the oil extract from the seed membrane can be
given to small children to improve growth (26).
Supplementation Trial
A supplementation trial was conducted from December 1997 to Februrary 1998 in HaiHung province, northern Vietnam. The objective of the trial was to assess the efficacy of
the traditional ß-carotene-rich rice preparation known as xoi gac for improving vitamin A
status of children in rural Vietnam. The length of the supplementation period was 30
days. The participants were 193 village children from 31 to 70 months of age in two
communes Doan-Ket and Tan-Trao of Hai-Hung province. The children were selected
from 711 village children in the above age groups. Selection criteria included a low
haemoglobin concentration (100-120 g/L), which has been associated with vitamin A
deficiency (36-38). The selected children were assigned to one of the three groups: a fruit
group that received rice cooked with gac containing 3.5 mg ß-carotene, a powder group
that received rice mixed with synthetic -carotene powder containing 5 mg ß-carotene,
and a control group that received rice without fortification. The usual vitamin A and
carotenoid intakes were assessed by a food frequency questionnaire administered to the
child’s mother before and after the supplementation.
Results
Plasma micro-nutrient concentrations
After the child's initial weight and ß-carotene values had been controlled for, the mean
increases in plasma ß-carotene concentrations among children in the fruit group
(106µg/dL;95% confidence interval 93 – 119 µg/dL) and powder group (83 µg/dL; 95%
confident interval, 66 – 101 µg/dL) were significantly higher than those of the control
group (5 µg/dL; 95% confident interval 2 – 7 µg/dL). The increase in plasma lycopene
concentration was significantly higher in the fruit group (940%) than in either the control
group (99%) or the powder group (386%). Plasma retinol concentrations increased
significantly in all three groups compared to initial values; the increase was significantly
higher in the fruit group than the other two groups. After supplementation, 52% of the
children in the fruit group and 47% of those in the powder group reached an adequate
haemoglobin concentration (120 g/L). Changes in the hemoglobin concentration of
children with a baseline value less than 110 g/L were significantly greater in the fruit
group than in the control group (mean difference 16.62 g/L, p <0.05).
Acceptance of xoi gac by the children
All children completed the 30-day feeding program. The attendance of children and
mothers at the feeding centre was 100%. One hundred and forty-six children (76%)
completed the entire portion (about 120g) every day of the study. The number of the
children who consumed the whole amount increased as the program progressed and on
the last day of supplementation most children expressed disappointment about the
termination of the programme. Eighty-four percent of the children in the fruit group,
72% of those in the powder group, and 76% of those in the control group completely
consumed the food. More children in the fruit group than in the other two groups
consumed the entire amount every day; however, the difference was not statistically
different.
Mothers’ health perception and usual consumption of xoi gac
Ninety-five percent of the mothers interviewed recognized that xoi gac is nutritious, and
66% said that their children had consumed xoi gac since the beginning of the season.
Eighty-four percent of the women prepared the xoi gac themself, 4% purchased xoi gac at
the market and 2% received it as gift. Few houses in the villages grew gac. Among the
mothers who prepared xoi gac at home, only 23% used gac from their home garden, 98%
purchased the gac fruit from the market, and only 1% received gac as gifts. Among the
46% of the mothers who did not give xoi gac to their children, 74% said that they did not
have gac fruit, 3% did not have money to buy gac, 4% did not have time to cook xoi gac,
and only 3% reported that the children did not like xoi gac.
The results of the trial suggest that xoi-gac is well accepted by the children. The provitamin A from Xoi Gac, a rich source of -carotene and lycopene, is highly bioavailable,
and that severely anemic children might benefit from -carotene supplementation.
Discussion
Under-utilization of gac fruit in Vietnam
Production and consumption of M. cochinchinensis (gac) fruit in northern Vietnam in
recent years has decreased for the following reasons. The local people have a poor
perception of the health and commercial benefits of the plant. There have been no efforts
to promote the production of gac fruit, and educate the target population about its
nutritional benefits. Consequently, land is allocated to cultivation of staples or crops that
bring greater commercial benefits, such as onion, black pepper, or potatoes. This
situation has been observed in other regions of the world (39). Traditional micronutrientrich plant foods have become less abundant and more expensive to obtain because their
production has fallen and/or not kept abreast with demand because of increased
population pressure. In fact, in many nations in Asia, consumption of vegetables has not
met the recommended per capita vegetable supply of 73 kg/year per person, the minimum
amount to prevent micronutrient malnutrition. Mean while, there has been a greater
research focus on increasing the production of calorie-rich staple crops such as rice,
wheat, corn, casava (40).
The gac fruit is only available three months out of the year. In Vietnam, gac vines are
grown mainly in the Red River Delta areas. Harvesting of the fruits begins on September
and lasts until December. Gac fruits are picked when they are at optimal size, weight,
and colour. Poor post-harvest handling and transportation reduce the shelf-life of the
fruit. After harvesting, fruits perish quickly and lose marketability after one week without
proper storage. In the markets of urban areas, gac fruits are available for only about 3
months, from November to January. A survey of mothers of participants in the
supplementation trial revealed that the main reason that mothers didnot feed xoi gac to
their children was the unavailability of gac. The use of gac fruit in making xoi gac has
declined, because synthetic food colourant is more available and economical. The
consumption of gac fruit will be increased if gac fruit is more available. Gac pulp can be
simply preserved in sugar, oil, or alcohol however there has been no effort to promote or
improve preservation of the fruit.
Improve availability of indigenous nutrient-rich plants to prevent micro-nutrient
malnutrition
The problems encountered in most food-based approaches to improving micronutrient
status are multifaceted. They include concerns about nutrient concentrations and
interactions in the selected food; bioavailability and bioconversion of the nutrient of
interest; and issues related to cultural sensitivity (41-43). Despite those problems,
solutions to micro-nutrient malnutrition that make used of local food sources offer many
benefits. The most apparent advantage is the self-sustainability of the program. Another
benefit is that the foods provide not only the deficient nutrients but also calories and other
nutrients. Another attributes to long-term success of a food-based strategies are the ready
acceptability to target groups due to familiarity. Improved production of the foods will
motivate the advancement of methods of processing, storing and preserving the foods,
which in turn not only will improve availability of the foods but also will increase
household income, which quite often is positively correlated with low nutritional status.
In the attempt to prevent micronutrient deficiency in developing countries by food-based
strategies, most efforts have been spent on fortifying foods with synthetic ingredients, or
supplying foods that provide the needed nutrients to populations, rather than finding local
sources of foods that contain the needed nutrients and promoting local production of
those foods. Fortification requires centralized, well-monitored food processing, and
effective distribution channels; this type of infrastructure is often rudimentary in third
world countries. Fortification of certain nutrients also changes the appearance and taste
of the food and renders it less desirable to the target population. The fortification of
sugar, monosodium glutamate and fish sauce has been tested in several countries in Latin
America and South-East Asia. None of the above fortification methods provides a
sustainatable solution to prevent vitamin A deficiency in developing countries. Daily
supplementation of needed micronutrients to prevent deficiency, requires commitment of
suppliers, often foreign sources, and is usually not appropriate to the local food habits,
hence this should only be a short-term measure.
Although the consumption of caloric by people in developing nations has increased since
the 1960s, the focus on staple crops such as rice and wheat, has resulted in the decreased
availability of micronutrient-rich food crops to millions of disadvantaged people and
contributes to the increase in micronutrient malnutrition namely ‘hidden hunger’ globally
(40,44). To rectify the problem of vitamin A deficiency in developing countries,
research efforts need to be directed towards identifying local plant foods rich in
provitamin A carotene (in addition to staple crops), traditional use of the plants, and
methods to improve production and/or preservation Compilations of plants available in
South-East Asia and their carotenoid contents have been made available by the work of
numerous researchers (34,45,46). For many of these plants, the local use should be
identified, because cooking and storing methods can change bioavailability of
carotenoids to humans (48). Advanced food processing techniques can be applied to
facilitate beneficial local usage, such as the use of provitamin A carotenoid-rich plants in
rice coloring or in seasoning of foods. Environment appropriateness and the plant matrix
are also important factors in the bioavailability of beta-carotene and should be considered
in the selection of plant sources of beta-carotene (21,49). Genetic manipulation of plant
genomes by traditional plant breeding or by genetic engineering has been applied to
characterize the genes that control the biosynthesis of carotenes in tomatoes, maize
kernels in carrot root (50,51). Currently these methods are under investigation to
increase the amount of provitamin A carotenoids in staple foods (rice, casava) (39).
These technologies and knowledge can be applied to improve the shelf-life of local crops
rich in provitamin A carotenoids, to provide continuously and currently available
provitamin A in fruits and vegetables, to overcome environmental stress and to enhance
marketability of indigenous fruits. Commercial and nutritional benefits will encourage
the cultivation of these carotene-rich crops, and their sustainability will be acheived by
maintaining sensible local traditions.
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Table 1. Summer and winter fruits and vegetables in northern Vietnam
Vietnamese names English names
Latin names
Rau lang
sweet potato leaves Ipomoea batatas
Rau mong toi
Ceylon spinach
Basella rubra
rau muong
water spinach
Ipomoea aquatica
rau day
jute potherb
Corhorus olitorius
rau ngot
sauropus leaves
Sauropus androgynus
rau bi
pumpkin leaves
Cucurbita pepo
rau cai cuc
chrysanthemum
Chrysanthemum coronatium
rau cai soong
watercrest
Nasturtium offcinale
rau cai xanh
mustard green
Brassica Juncea
rau cai bap
cabbage
Brassica oleracea
rau can
celery water
Oenanthe stolonifera
rau cai thia
Chinese cabage
Brassica spp.
rau rut
Neptunia oleracea
gia
mungbean sprouts
Vigna radiata
khoai lang
sweet potato
Ipomoea batatas
ngo
corn
Maize
hanh
onion
Allium cepa
ca chua
tomato
Solanum lycopersicum
ca rot
carrot
Daucus carota
xu hao
kohlrabi
Brassica oleracea
ca bat
aubergine
Solanum melongena
ca phao
eggplant
Solanum melongena
bi do
pumpkin
Cucurbita pepo
bi xanh
ashgourd, waxgourd Benincasa cerifera
khoai tay
potato
Solanum tubersorum
muop dang
bitter melon
Momordica charantia
bac ha
Colocasia indica
gac
spiny gourd
Momordica Cochinchinensis
muop
sponge gourd
Luffa cylindrical
mang
bamboo shoot
Bambusa spp.
du du
papaya
Canca papaya
chuoi
banana
Musa sapientum
quit
madarin orange
Citrus reticulata
buoi
grapefruit
Citrus maxima
vai
lychee
Litchi sinensis
dua
pineapple
Ananas sativus
chanh
lemon
Citrus limon
ot
chilli pepper
Capsicum frutescens
cam
orange
Citrus sinensis
khe
star fruit
Averrhoa carambola
dua hau
watermelon
Citrusllus vulgaris
dua chuot
cucumber
cucumis sativus
dua gang
large cucumber
cucumis melo
ga
c
go
ur
d
po
ta
to
ju
ju
be
ba
na
na
m
an koh
da
lr
rin abi
or
an
ge
to
m
at
o
pa
pa
ya
m
ya
sw us
m
ee tar
d
tp
g
r
ot
at een
o
le
wa
te ave
s
rs
pi
n
cr
a
ow ch
n
da
is
y
ca
bb
ju
te age
po
ca
t
sa her
b
va
le
av
es
20000
18000
16000
14000
12000
10000
8000
6000
4000
2000
0
wa
x
mc g/100g
Table 2. Beta-carotene contents of gac and other commonly consumed fruits and
vegetables in northern Vietnam. Source: refs. 18 and 19
Table 3. Names of Momordica cochinchinnensis in different languages
Language
Latin
Indian
Chinese
English
Japanese
Hindu
Laos
Malais
Thai
Vietnamese
Name
Momordica Cochinchinnensis Spreng
Muricia cochinchinnensis Lour.
Muricia mixta Roxb.
Bhat kerala
Moc Niet Tu
Spiny bitter gourd
Sweet gourd
Cochinchin gourd
Kushika
Mokubetsushi
Hakur
Kakrol
Kakur
Mak kao
Teruah
Fak kao
Gac
Table 4. Approximate nutrient composition of Momordica cochinchinensis spreng (per 100g of edible portion)
Fruit1[1]
Seed pulp2[2]
1[1]
2[2]
From ref. 52
From ref. 19.
Water
%
90.2
77
Calories
Kcal
29
125
CHO
g
6.4
10.5
Protein
g
0.6
2.1
Fat
g
0.1
7.9
Fiber
g
1.6
1.8
Ash
mg
-car
g
0.7
45780
Ca
mg
27
56
P
mg
38
6.4
Table 5. Fatty acid composition of gac pulp
shorthand name
14:0
16:0
16:1
18:0
18:1n9
18:1n7
18:2
18:3n3
20:0
20:1
20:4
22:0
24:0
myristic
palmitic
palmitoleic
stearic
oleic
vaccenic
linoleic
alpha linolenic
eicosanoic
gadoleic
arachidonic
docosanoic
tetracosanoic
TOTAL
mg/100g edible portion % total fatty acids
89
2248
27
720
3476
115
3206
218
40
15
10
19
14
0.87
22.04
0.26
7.06
34.08
1.13
31.43
2.14
0.39
0.15
0.10
0.19
0.14
10,198
mg / 100g edible portion
type
saturated
saturated
unsaturated
saturated
monounsaturated
monounsaturated
polyunsaturated
polyunsaturated
saturated
monounsaturated
polyunsaturated
saturated
saturated
Picture 1.
Momordica Cochinchinnensis Spreng (gac) - flowers, leaves, fruit, and seeds
Reproduced from ref. 34
Picture 2.
A sectioned Gac fruit showing many red seeds inside
Picture 3.
Xoi gac, a rice preparation of white rice reddened by the gac pulp. Seeds are left with the
rice as a proof of authenticity.